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�iftJ LDG hhiIABER <br /> ZAN Jt„.�UIN COUNTY'PURLIC HEALTH ... VICES <br /> (� ENVIRONMENTAL Ht-ALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCK ON CA 95202 <br /> (209)488-3420 <br /> 'PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT 4-L' BiJSIIlESSJAGFNCY COv Ov czr't' tkv%_0 Lo <br /> cam. — <br /> ADpI2ESS Ia Frav+Lc G�I�� F .tiv�c�ei - C/a $5'2..4 (.- <br /> TENTATIVE*APMINTMEN-TDATE 1I 30f Z-�*¢ 1 'nmE <br /> (Pleases W"7 to 10 b 1416"days f M date of application S—"b Uwi <br /> IN <br /> CHECK>aOX TO ExP'E.DrM REQUEST U7.00 FEE-R uEs P � =94 3 BUSINESS GAYS <br /> 01 <br /> SIGNATURE OF APPLICANT DATE ti 1"! Z--14+"7 <br /> FILE ADDRESS THIS S1D�EfiD 97'AFF IISfi ONLY <br /> 11 PROGRAM EL.FJi AM SEARCH <br /> -4 Z 0 .S. r...a..r 1 z a„�n c.1t�77 i� ' <br /> - <br /> 2.tG,�.EirY►i� <br /> 'S 2- A r c...H <br /> /'� ENVIRONMENTAL HEALTH DivlslON FILES <br /> yNDERGROUND TANK(UST)CLEANUP ZM(LOP) L'7 HQUSINC ABATEMENT 0 SOLJD WASTE FACILITY <br /> a ER CLEANUP SIVE(NON-LOP) MFOOD FACIL" C7 SOLID WASTE VEHI= <br /> NDFRGROUND TANK(MONITORINCUREMOyAL) _ 0 DOG KENNEL 0 DAIRY <br /> EF HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH ,Ll PKG TWATMENT PLANT <br /> a TIeRZ0 PERMrJ TM FACIL1TY Q MO'TELIHOTFJ- b PIiMPER TRUCKJYAMCHEM'TOILETS <br /> M_TATTQ0MO0YFM0RCING Q PdoLiSPA Q LAND USE APPUCATtoN SITES <br /> W MEDICAL WASTE FACIL17 Y Cl PUBLIC WATER SYSTEM CI OTWR(PLEASE SPECIFY ABOVE) <br /> 7. List up to tern addresses in the space above_ Select the types)of files from the list above by checking <br /> the appropriate box(es). At least one fila:type MUST be selected. Fax tof2g9)464-0138 or In to ttto <br /> add 'ndlcated <br /> 2. EHD will notify the appllcant if any EHO files exist. An appointment for neview•will be confirmed <br /> approximately five business days but no later than ten(10)days after receipt of application. The flies <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that Is actively being worked on by EHD staff may not be immediately available for review. A new <br /> application may he submitted when the file is available. <br /> 4. Any file not returned in,the same condition as released will be reorganized by EHO staff at the expense <br /> of the applicant, Future file reviews by the same applicant may require a$87.00 deposit prior to review. <br /> 5. *TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE �.� TIME <br /> DATE CONFIRMED -- _ . PHONE FAX INITIALS <br />